|
| Sirolimus-eluting 1481 | Paclitaxel-eluting 1407 | Total 2888 |
| On-label characteristics for use of a drug eluting stent |
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|
|
0 | Use of only one stent irrespective of length with nominal diameters ranging from 2.5 to 3.5 mm in de novo lesions in native vessels and none of the off-label lesion or patients characteristics below | 74 | 64 | 138 |
| Off-label characteristics for use of a drug eluting stent |
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1 | Use of stent in a re-stenotic previously stent-treated lesion [8] - [18] | 25 | 48 | 75 |
2 | Use of stent in a vein graft. This combines and replaces: “degenerated vein grafts with friable lesions” (C-lesion, Table 6 in [5] ) and “use of stent in bypass grafts” be it arteries or veins [7] - [18] | 10 | 13 | 25 |
3 | Use of stent in the left main coronary artery [6] - [8] [10] - [12] [14] - [19] . Irrespective of it is being protected by a previously performed CABG or by a fine arterialized collateral or whether it seems to be unprotected | 14 | 20 | 37 |
4 | Use of stent within 5 mm from the ostium [6] - [8] [10] [12] [15] [16] LAD2, LAD3, CX2, CX3, RCA2, RCA3 have no ostium | 257 | 243 | 509 |
5 | Use of stent in bifurcation lesion [6] [7] [9] - [19] (i.e. a lesion where a balloon has been inflated in each of the branches of the bifurcation) | 125 | 124 | 272 |
6 | Use of stent in an occlusion excepting acute myocardial infarctions treated acutely. This combines and replaces “use of stent in total occlusions more than 3 months old and/or bridging collaterals” (C-lesion, Table 6 in [5] ) and “use of stent in a chronic total occlusion” [9] - [12] [14] - [18] | 114 | 145 | 272 |
7 | Use of nominal stent diameter < 2.5 mm―our own definition which replaces use of stent in reference vessel diameter < 2.5 mm [6] [7] [10] [13] [15] - [18] | 128 | 119 | 257 |
8 | Use of more than one stent in the same lesion, which replaces use of stent in lesion lengths > 26 mm [16] , >28 mm [7] , >30 mm [6] [8] [10] [11] [15] [18] or >36 mm [19] and at least 2 overlapping stents [7] [8] [16] | 260 | 265 | 558 |
9 | Use of stent length > 20 mm, a high risk lesion (C-lesion, Table 6 in [5] ) | 518 | 454 | 1025 |
10 | Use of stent in angulated lesion, a high risk lesion (C-lesion, Table 6 in [5] )―in this context > 45 degrees as was our own definition prior to publication of guideline [5] which defined > 90 degrees | 277 | 254 | 535 |
11 | Use of stent in vessel with severe proximal tortuousity, a high risk lesion (C-lesion, Table 6 in [5] )―replaces the “use of stent in a tortuous vessel (>60 degrees) in the region of the obstruction or proximal to the lesion” [6] [7] | 289 | 245 | 538 |
12 | Use of stent in lesions with visible thrombus at lesion site [6] [7] or distal to lesion | 95 | 89 | 187 |
13 | Inability to protect major side branches, a high risk lesion (C-lesion, Table 6 in [5] ), here defined as side branch > 1 mm in reference diameter | 324 | 305 | 631 |
| Patient characteristics for off-label use of stent |
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14 | Use of stent in patients with STEMI [6] - [9] [11] - [14] [16] - [19] in an acute/emergency setting | 205 | 185 | 422 |
15 | Use of stent in patients with non-STEMI [9] [11] or unstable angina in a sub-acute/urgent setting which replaces: “use of stent in patients with acute coronary syndromes” [18] and “use of stent in patients with a recent AMI where there is evidence of thrombus or poor flow” [6] [7] | 531 | 462 | 1049 |
16 | Use of stents in more than one lesion [19] which also encompass use of stent in patients with multi-vessel disease [9] [14] [17] [18] | 669 | 602 | 1385 |
17 | Use of stent in patients with diabetes [11] [14] | 248 | 234 | 509 |
| Of special interest―although not an off-label characteristic |
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18 | Use of DES in female gender | 364 | 308 | 716 |
| Not included in the present analysis due to absent data |
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19 | Use of stent in patients with left ventricular ejection fraction < 0.30 [12] (or <0.25 [19] ) | “not available” | “not available” | “not available” |